Objective: To evaluate the efficacy and side effects of a multiple-source, constant-current device in a Latin-American population of patients with PD.

Background: Timmermann et al. 2015 demonstrated the effectiveness of a multiple-source, constant-current device in subthalamic deep brain stimulation (DBS) with fewer side effects to improve motor function and quality of life in patient with Parkinson´s disease (PD).

Methods: A descriptive study of 11 patients with PD that underwent bilateral implantation in the subthalamic nucleus of a multiple-source, constant-current, eight-contact, rechargeable DBS system. Patients were assessed at baseline (medication-off state), and at 6 and 12 months after leads implantation (stimulation-on, medication-off state). Tests performed include The Movement Disorder Society-Unified Parkinson’s disease Rating Scale Part I-II-III (MDS-UPDRS I-II-III) score and the 39-item Parkinson’s disease Questionnaire (PDQ-39). Side effects were recorded at each time point.

Results: Eleven patients was included, mean age 56.9± 6.97years, six males, with an average evolution time of PD before implantation of 9,36years. Thus far, 9 and 6 patients have reached the 6 and 12 months’ time-points, respectively; data are presented as median and interquartile range (IQR) for these patients. Improvement was noted in the MDS-UPDRS III motor score (stimulation-on, medication-off state) of 18 points [IQR:14-27] at 6 months and 19 points [IQR:11-25] at 12 months compared with baseline 46 points [IQR:41-60], a mean reduction of 54,4% and 55,6%, respectively. An improvement in quality of life was also found with a PDQ-39 score of 91points [IQR:60-109] at baseline that improved 72,6% at 6 months (22points, IQR:15-23) and 48,9% at 12 months (31points, IQR:2-49). The baseline average dopaminergic medication dose was 1311+/-272mg, with a mean reduction at 6 and 12 months of 74%(328+/-254mg) and 67,2%(415±282mg) respectively. Any patient died. Complications related to surgery were one case of urinary tract infection and other of symptomatic frontal hematoma. Complications related to programming most frequent were reversible dyskinesia and capsule effect. The stimulation remained on during the study.

Conclusions: The multiple-source, constant-current, eight-contact, rechargeable DBS system improves motor symptoms and quality of life in patients with PD, with an acceptable safety profile.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/multiple-source-current-steering-in-bilateral-subthalamic-nucleus-deep-brain-stimulation-for-parkinsons-disease-our-experience/